Technology of PPP – Recipe for Success in Healthcare

In order to overcome the problems such as malnutrition, lack of infrastructure and health coverage, the government has entered into various MoUs, says Mukesh Sharma, Principal Secretary, Medical, Health & Family Welfare and Medical Education, Government of Rajasthan in conversation with Kartik Sharma of Elets News Network (ENN)

What are the challenges in the health sector in Rajasthan at present?

Rajasthan is facing many challenges in healthcare sector. Rajasthan is geographically the largest state of India and it has many disadvantages also as it has large desert, tribal, hilly and remote areas. Population is scattered, so reaching to every village and cluster is the biggest challenge for the healthcare sector. Although, we are making concerted efforts to overcome this problem, shortage of doctors is a cause of concern for the Government of Rajasthan. Many innovative ideas have been tried recently. Apart from this, getting experts for super specialty in healthcare services is also becoming a problem because of which we are not able to make trauma centres functional.

PPP in healthcare in Rajasthan is becoming a role model. How do you look at it?

Public-Private-Partnership (PPP) is a keyword these days in the state and central governments, several departments are using PPP as a panacea for many problems. We often see that entrepreneurship and management elements are normally not present in the required quantity in the government set up, therefore, to bring these elements into the public services, PPP seems to be a very viable model. We have invited PPP in many fields in our budget announcement 2015-16, Ho’nable Chief Minister has announced many PPP initiatives in the healthcare sector. In our district hospitals, many facilities are required to be provided through PPP in which some diagnostics and some super-speciality services will be offered to the patients by inviting open offers from corporate sector, private hospitals and groups.

What are the new innovations which have been used to overcome the problem of shortage of doctors and specialists?

As I have mentioned that the paucity of doctors is the biggest challenge for Rajasthan but in the last one year many steps have been taken by the government to overcome this problem. The Medical, Health & Family Welfare Department has invited many MBBS doctors for a one-year-long PG course in which some super specialities have been defined. By imparting this one-year training on the doctors, we can operate our trauma centres and various other facilities effectively. Secondly, walk-ininterviews have been allowed by the government to allow MBBS doctors to contact the district administration. The district administration along with Chief Medical Health Officer can take a direct interview to recruit doctors fulfilling the basic criteria. We have also proposed a hard area allowance like in tribal districts or ten high-priority districts as rated by the Government of India, doctors are being given incentives ranging from `6,000-25,000.

Please tell us about integrated ambulance system and its operations?

Integrated Ambulance System (IAS) is a very innovative idea, which has been announced by Ho’nable Chief Minister in her budget announcement of 2015-16. There are multiple ambulance systems in any state. In Rajasthan, we have 108 service, which is run by GVK Emergency Management and Research Institute (EMRI) where a call is attended when there is a need of medical attention or fire or police. Then 104 is a state run facility where Janani Express vans or ambulances are run by Chief Medical Health Officers and the funding is done by Government of India.

There are base ambulances financed by the state government entirely whose capital and running costs both are borne by the state government independently. In IAS, we have combined all the three types of ambulances along with the helpline, which is a medical advisory service. The RPF has been made in such a way that the service provider will run all the ambulances and the helpline and an integrated system would come in place to empower total medical system and give more avenues to the people for availing mobile medical units.

What are the benefits of recent MoUs signed between Rajasthan Government and Tata Trusts, Global Alliance for Improved Nutrition (GAIN) and WHO?

Rajasthan is facing many problems like malnutrition, universal health coverage because of huge population and lack of required infrastructure to deal with such problems. In order to overcome these problems, the government has entered into agreements with UNICEF and GAIN. GAIN will be executing agency with our medical machinery. In March, we had signed an agreement with Tata Trust and Antara Foundation where they will try best practices and suggest how healthcare services should work in entire Rajasthan. In the first phase, they have chosen Sirohi and Jhalawar districts and if their experiment proves to be good, then it would be emulated in the entire state in the coming years. We have also entered into MoU with the WHO to learn how we can implement the Universal Healthcare Coverage (UHC) elements in Rajasthan.

How you think SMS Hospital can be made an ideal destination for super speciality needs?

Sawai Man Singh (SMS) Hospital is one of the largest hospitals in India. We are getting huge footfall from Uttar Pradesh, Delhi, Haryana and Uttarakhand as we are providing free medicine to a larger number of patients. It is a huge challenge to meet people’s expectations and the massive crowd. Now, we are also trying some new experiments like organ transplant and our doctors are getting trained to launch organ transplant services. We would also set-up Hospital Security Force to look into a scuffle between hospital staff and patients.

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